O'Donnell Christopher J, Elosua Roberto
National Heart, Lung and Blood Institute's Framingham Heart Study, Framingham, Massachusetts 01702, USA.
Rev Esp Cardiol. 2008 Mar;61(3):299-310.
Epidemiology involves the study of disease frequency and its determinants within the population. Cardiovascular epidemiology began in the 1930s as a result of changes observed in the causes of death. In the 1950s, several epidemiological studies were set in motion with the aim of clarifying the cause of cardiovascular disease. Four years after the Framingham Heart Study started, researchers had identified high cholesterol and high blood pressure levels as important factors in the development of cardiovascular disease. In subsequent years, the Framingham study and other epidemiological studies have helped to identify other risk factors, which are now considered classical risk factors. By coining the expression "risk factor", the Framingham Heart Study helped to bring about a change in the way medicine is practiced. Today, a risk factor is defined as a measurable characteristic that is causally associated with increased disease frequency and that is a significant independent predictor of an increased risk of presenting with the disease. This wide-ranging overview describes some of the most important insights into the causes of cardiovascular disease to have come from the Framingham Heart Study. The emphasis is on the identification of risk factors, and the assessment of their predictive ability and their implications for disease prevention.
流行病学涉及对人群中疾病频率及其决定因素的研究。心血管流行病学始于20世纪30年代,是观察到死亡原因发生变化的结果。20世纪50年代,开展了几项流行病学研究,旨在阐明心血管疾病的病因。弗明汉心脏研究开始四年后,研究人员已确定高胆固醇和高血压水平是心血管疾病发展的重要因素。在随后的几年里,弗明汉研究和其他流行病学研究有助于确定其他风险因素,这些因素现在被视为经典风险因素。通过创造“风险因素”这一表述,弗明汉心脏研究有助于改变医学实践方式。如今,风险因素被定义为一种可测量的特征,它与疾病频率增加存在因果关联,并且是患病风险增加的重要独立预测指标。这一广泛概述描述了弗明汉心脏研究对心血管疾病病因的一些最重要见解。重点在于风险因素的识别,以及对其预测能力及其对疾病预防的影响的评估。